Debates of Feb. 24th, 2015

Opposition Motion—Special Committee on the Supreme Court of Canada decision in Carter v. Canada

[Sean Casey, Liberal, Charlottetown, PE]

Mr. Speaker, the member is another of my colleagues who, as a result of having worked with her on the justice committee, has genuinely earned my respect.

With respect to that question, the short answer is yes. It is our hope that the committee, regardless of its composition, regardless of party stripe, would really be able to put that aside and work in a nonpartisan manner in the interest of Canadians.

Is it necessary to have the committee balanced by parties for that to happen? I would hope not, but if that were the will, there is no reason we would not be open to that. I would hope that on an issue like this, the composition of the committee in terms of party members would not be that important. A balanced committee would be one we would be hard pressed to argue against and would absolutely send the right message.

[Bob Dechert, Conservative, Parliamentary Secretary to the Minister of Justice]

Mr. Speaker, I am pleased to have an opportunity to participate in today's debate on the way forward in responding to the recent decision by the Supreme Court of Canada on the issue of physician-assisted dying.

The issue of physician-assisted dying is very complex and evokes a range of deeply held feelings and responses that depend in large part on the experiences of each individual. Perspectives cut across demographic, political, and religious lines. This is a personal issue, above all else.

The member for Papineau, the Liberal leader, mentioned earlier that his views were informed by the last days he spent with his father. I think we have all had those personal experiences. I certainly went through that with my parents, with other family members, and with good friends. I think every Canadian has lived through a situation with a loved one where they saw a difficult end-of-life situation. We all have a view on this, and I think Canadians broadly need to be consulted in the process, because it is such a personal thing to every Canadian.

This issue will require us to confront the reality that every one of us will face death and the possibility that each of us will experience suffering at some point in our lives that may make it necessary to seek the assistance and support of others. These are fundamental aspects of what it means to be human.

I would like to assure all members that our government fully appreciates the serious nature of the challenges that lie ahead. We will be opposing the motion, because we intend to launch meaningful consultations soon with Canadians and key stakeholders so that we can hear all perspectives on this difficult issue.

It will be imperative for Canadians to also appreciate the complex and difficult nature of these issues. There are no easy answers here. We will ensure that during the months to come Canadians understand the subtleties of the issues before us and also understand the existing landscape of health care options at the end of life. For instance, every person can refuse treatment or stop treatment that has already been started, even where the result is that they will die. Many Canadians may be unaware of this existing right. Many seem to believe that physician-assisted dying means that they would now have the right to refuse life-prolonging treatment at the end of life. We must ensure that everyone understands what is already legal so that they are not confusing these measures with physician-assisted dying.

More specifically, we are here today because on February 6, 2015, the Supreme Court of Canada concluded that the Criminal Code provisions on physician-assisted dying are contrary to the Charter of Rights and Freedoms. In so doing, the court reversed its own previous decision in the Rodriguez case, decided in 1993, just over 20 years ago. This time, the Supreme Court found that the prohibition deprived some people of the right to liberty and security of the person, which encompasses protection for choice and autonomy in fundamental life decisions about one's own body. It also found that the provisions deprived some people of the right to life, because they have the effect of forcing them to end their lives prematurely for fear that they will be unable to do so when the suffering becomes intolerable. These deprivations were held not to be in accordance with the principles of fundamental justice. The court also held that the charter recognizes the value of life and honours the role autonomy and dignity play at the end of that life.

The court came to its conclusion after having considered the situations of the particular claimants in this case, in particular Gloria Taylor. In 2009, Ms. Taylor was diagnosed with amyotrophic lateral sclerosis, also known as ALS, a fatal neurodegenerative disease that causes progressive muscle weakness. ALS patients first lose the ability to use their hands and feet, then the ability to walk, chew, and swallow, and eventually to breathe. For Ms. Taylor and people like her, the court found that the prohibition on physician-assisted dying left her with what she described as a cruel choice between killing herself while she was still physically capable of doing so or giving up the ability to exercise any control over the manner and timing of her death.

The court concluded that the charter protects the right to physician-assisted death for competent adults who clearly consent and who have a grevious and irremediable medical condition, including an illness, disease, or disability, that causes enduring and intolerable suffering. As a result, it found two sections of the Criminal Code to be unconstitutional: the criminal prohibition against assisted suicide and the rule that a person cannot legally consent to death being inflicted upon oneself. The court found that the purpose of these laws was to protect vulnerable individuals from having their lives ended in times of weakness or through the coercion or abuse of others.

Since these laws apply to everyone, the court found that they violated the rights of individuals who are not vulnerable and who want to have physician-assisted death when they are grievously or irremediably ill.

The court also confirmed that Parliament's criminal jurisdiction includes the power to prohibit or regulate medical treatments, because they are dangerous. At the same time, it also affirmed that both the federal government and the provincial and territorial governments can legislate with respect to health, depending on the aspect being legislated.

The court suspended the legal effect of its ruling for 12 months in order to give Parliament time to develop an appropriate legislative response. During this time period, physician-assisted dying remains illegal.

While the Supreme Court framed its judgment around the concept of physician-assisted dying, I believe it is important at this early stage of the debate to distinguish between physician-assisted suicide and voluntary euthanasia. Physician-assisted suicide is when a physician provides a patient with the means to end their own life, such as by prescribing a lethal dose of medication that the patient then self administers. Voluntary euthanasia occurs when a physician actively causes a person's death at their request, typically through a lethal injection.

From the perspective of a person who is suffering intolerably and wishes to die with a physician's assistance, these two practices may appear indistinguishable. However, from the current criminal law perspective, they are different crimes with different penalties.

Under the current law, voluntary euthanasia meets the definition of murder, even when it is motivated by compassion or mercy, and even when the person requests or consents to dying. Murder is the most serious offence in our criminal law and is punishable by a mandatory life sentence. In contrast, a physician who aids a person in taking their own life falls within the offence of assisting suicide. This offence is punishable by a maximum of 14 years in prison.

Of the few jurisdictions that now regulate physician-assisted dying, some permit only euthanasia, some permit only assisted suicide, and some permit both. There is evidence suggesting that the risks and implications of the two practices are distinct. These are important distinctions to bear in mind.

The Supreme Court was clear in stating that it was confining itself to assessing the rights of those who would seek assistance in dying, rather than of those who might be tasked with providing such assistance, namely physicians. However, the reality is that the legal effect of the ruling is to require that the criminal law free physicians from criminal responsibility for their participation in helping some people die, or in actively causing death.

The fact that the law must now permit a zone of lawful participation in bringing about the death of others, however, raises some concerns. Many such concerns were raised before the courts in the Carter litigation as reasons justifying the absolute prohibition of these practices. Although the court has now rejected those arguments with respect to an absolute prohibition, this does not mean that those concerns and risks are not important and legitimate considerations moving forward. Indeed, the trial judge and the Supreme Court were clear that those risks and concerns are real. I would like to quote from the trial judge, who said:

...the risks inherent in permitting physician-assisted death can be identified and very substantially minimized through a carefully-designed system imposing stringent limits that are scrupulously monitored and enforced.

I consider this to be a key passage in the trial judgement, and it is one that is referred to several times by the Supreme Court. There are several things to note in this passage. First, the trial judge found that there are risks inherent in permitting physician-assisted dying. These risks will be borne by vulnerable individuals. Second, the risks can be identified and substantially minimized through a carefully designed regime with stringent limits and safeguards, although they cannot be eliminated entirely. Third, the limits and safeguards must be carefully implemented, monitored, and enforced.

This passage helps us see the path that lies ahead. We will need to identify the various risks to vulnerable individuals so that we can design a regime with limits and safeguards aimed at minimizing their occurrence. We will also need to consider mechanisms to ensure that physicians are clear about the law and how to apply it, and that the relevant authorities will be equally vigilant in monitoring and enforcing any violations.

The courts agree that there is no room for complacency, either in designing a legislative response or in its implementation. In my view, we must be very careful in designing these procedures. There is a lot that we already know about the nature of these risks. A great deal of evidence was presented to the courts in the Carter litigation about those risks.

Some risks that have already been identified relate to the difficulties that physicians may have in detecting whether a person's request to die is affected by depression or by the influence of third parties, such as family members. This last concern is especially acute in relation to the elderly. As we all know, elder abuse is a growing concern. All too often, people take advantage of a trust that an elderly person places in them. It is far from inconceivable that an adult child of an elderly person could suddenly suggest to him or her that he or she has lived a full life and no longer needs to suffer in a weakened or ill state. Adult children who may be eager to get at their parents' estate could conceivably try to influence their parent to choose assisted dying.

As a lawyer, I am very concerned about undue pressure on and manipulation of sick and elderly persons by unscrupulous beneficiaries. Anyone who has practised law in this country, and especially in the area of wills and estates law, would know about this. These lawyers have seen situations where elderly people have been subjected to a lot of pressure to enter into a certain will arrangement, in particular testamentary trust arrangements, which takes it to a different level. We need to be very cautious about how we proceed in this area. We would hope that such things would never happen, but in this process we will only hurt vulnerable individuals if we naively assume that such behaviour is outside the realm of possibility. The real question is how to guard against its resulting in an unwanted death.

Other risks relate to concerns that individuals could choose to seek death because of a faulty diagnosis or prognosis. While medicine is a science, diagnosing illness and disease and prognosticating over how long a person with an illness has to live are difficult medical determinations. My own father was a medical practitioner. He is retired now, currently in a hospital in Hamilton, Ontario. He told me many times about diagnoses that changed over time and test results that were inconclusive. As a child, I remember his telling me of a patient he had in Toronto about 40 years ago. A young man was injured in a high-school football accident and was in a coma for 21 years. After 21 years, he woke up and walked out of hospital one day. His mother sat by his side every single day for 21 years. Science is expanding all the time, but every day we learn more about the human body and its ability to heal itself.

My father graduated from medical school in 1953, and his entire career was about prolonging life and saving life. I worry about future generations of medical students and how they will deal now with the added responsibility to consider how to end a life.

There was also evidence presented to the court that persons with disabilities would face special risks under a regime that is overly permissive. The trial judge accepted evidence that people with disabilities face prejudice in the health care context because some physicians have subconscious biases that cause them to presume that the quality of life of disabled individuals is lower than those disabled individuals subjectively experience it to be. One concern is that a request to die from a person with a disability would too easily be accepted by his or her physician and that not enough time and energy would be spent looking behind the words to understand the reasons for the request. At a more general level, the concern of disability rights groups is that physician-assisted death would suddenly reinforce the more generalized social prejudice and stereotypes that disabled lives have less value and quality than those of other Canadians. Many disabled individuals find the assumption that life with a disability is less meaningful or somehow of lesser quality to be devaluing. We must take these concerns seriously.

Again, my experience is informed by my own personal experience with my late mother who passed away three years ago, suffering from the effects of Alzheimer's. Her last five years were not good. She was confined to an over-sized wheelchair. She had to be lifted in and out of that chair and in and out of bed. Many times she did not know where she was or who she was or to whom she was speaking. However, even in the final year, some days, out of the blue she would say something that was extremely appropriate, that was pithy, that was apropos to the moment, that was insightful, and we never knew when that would happen.

My brother and sister and I struggled to bring her out of the care home she was in to attend family events. There had to be special logistical arrangements and special caregivers, but every moment we spent with her was worthwhile, and we all wish that she was still with us today.

At a more general level, to be sure, there are differing views within the disability community, but these are the concerns that have been voiced by large national organizations in Canada and abroad. Hearing all voices over the coming months will be of critical importance, so that we can develop adequate responses and safeguards that affirm the equal and inherent dignity and value of all Canadians, including those with disabilities.

Many are likely to view the question of physician-assisted dying as a private matter between patients and their doctors when viewed through the lens of the single individual who genuinely and desperately wants to die because he or she has a medical condition that is causing intolerable suffering. The question of legalizing physician-assisted dying does appear to be a private one.

From the perspective of a person who truly wants to die, the issue may seem like a relatively simple one. However, as I have described, there are many issues that must be considered from the broader public perspective.

Some people may choose assisted dying after having lived a vibrant and full life, with the support of family and friends, after having been able to accomplish all of their dreams. However, not everyone is so fortunate. Some people may choose death as the most reasonable option because they are not supported by their families, they are lonely, or they are lacking the resources necessary to make life manageable. If these individuals request assistance to die from their physicians, how should they be treated?

There are likely several different options for a possible way forward on this issue. It would be critical to review the existing regimes internationally, as was done by the courts in the Carter decision. At present, they seem to fall into two groups. In the United States, there are three states—Oregon, Washington, and Vermont—that have legalized physician-assisted suicide only through a prescription of a lethal substance for those who are terminally ill. By contrast, three countries in Europe—Belgium, the Netherlands, and Luxembourg—have legalized and regulated euthanasia for persons suffering intolerably from any kind of medical condition.

Under these regimes, most people who obtain euthanasia are cancer patients at the end of life, but there are a growing number of people with psychiatric disorders and other types of conditions that are not life threatening. Difficult choices will need to be made. Do we as a society see the suffering of those who are dying differently from the suffering of those who still have a lot of life left to live? Are we doing all that we can to alleviate suffering in various forms?

I would like to mention palliative care at this point and pay special tribute to those very special people, the caregivers, nurses, and doctors, who work in the palliative care field. They are truly special angels and deserve our supports and thanks. I have seen family members go into palliative care and have a much better situation at the end of life than without it. That needs to be part of our debate. Any time that I think I have a difficult day at the office, I think of those who work in palliative care. God bless them.

How will we ensure that suicide prevention initiatives continue to improve while we offer assistance in death to some people? How can we help Canadians be less afraid to talk to their doctors and families about death and dying and consider preparing advance directives setting out their wishes if they should become unable to express their wishes?

Physician-assisted dying raises many difficult issues of great importance to all Canadians. It involves matters of life and death, questions of human dignity and suffering, and the inherent value and equality of all Canadians no matter what their medical conditions, age, or physical limitations and challenges. These are very profound questions. Our government opposes this motion because we have committed to consulting widely with Canadians in a meaningful and effective way. This will take some time and it behooves us to take the appropriate time now to carefully consider all perspectives and options.

We must all come together to work out solutions in a respectful and compassionate way. How we resolve these often conflicting values will speak to who we are as a society for many years to come. In my view, the special committee structure and the timeframe suggested in the Liberal motion would not allow for the proper consideration of all aspects of this very serious matter.

[Carolyn Bennett, Liberal, St. Paul's, ON]

Mr. Speaker, some of the steps the member outlined, particularly his phrase, “we must all come together”, speaks to the need to get on with this.

I am concerned that the member for Kitchener Centre and the member for Saskatoon—Wanuskewin have already decided that the “notwithstanding” clause should be implemented, and that the member for Vegreville—Wainwright already thinks there is not enough time and that the Conservatives need an extension.

Could the member explain to me why it is important for not only for his caucus to have a proper conversation? Why can we not do what Preston Manning has said and let the the people speak in Parliament in a transparent way so we can get this right? What would be the way to all come together and listen to Canadians, rather than a conversation in some backroom with where Conservative members of Parliament are told what to do?

[Bob Dechert, Conservative, Mississauga—Erindale, ON]

Mr. Speaker, I regret the partisan tone of that question.

In fact, we are suggesting that tens of thousands, perhaps hundreds of thousands, of Canadians need to be heard on this issue. The member will know that committees are very limited in the number of people from whom they can hear.

My colleagues who are here today and who serve on the justice committee know that we went through a similar process with the prostitution decision in response to the Bedford case last year when we reviewed the prostitution legislation. Even though we sat for quite a period of time during the summer and heard from witnesses 6 hours a day, the most we could hear from was maybe 8 or 10 witnesses per hour. There are just not enough hours in the day to hear from the number of people who need to be heard on such an important issue as this.

We need to reach out to all Canadians. We need to have a broad public consultation process. Then we need to collect that information. We need to craft a response to it. Then it will go through the committee process. That should begin soon, and I am quite confident that it will.

[Françoise Boivin, NDP, Gatineau, QC]

Mr. Speaker, I thank my colleague, the Parliamentary Secretary to the Minister of Justice, for his speech, and I want to say that I listened closely to his answer to the Liberal member.

The prostitution example the parliamentary secretary gave was not particularly comforting if we were hoping to have a non-partisan consultation.

That was one of the problems with the prostitution legislation in response to the Bedford decision. Many people told us that the government was only consulting the people it wanted to consult.

Can the Parliamentary Secretary to the Minister of Justice tell the House whether the opposition parties and the members who represent non-recognized parties in the House will be able to participate in the process the Conservatives envision and whether the government will truly consult broadly?

I want to hear opinions from everyone: those who support assisted death, those who are against it, those who are undecided and those who agree to a certain extent.

I do not want to feel as though the vision of the government and the Prime Minister's Office is the only option. This is an extremely serious and emotional issue for many people. It affects a lot of the people we all represent in the House, and they deserve to be heard.

[Bob Dechert, Conservative, Mississauga—Erindale, ON]

Mr. Speaker, I enjoy working with the member on the justice committee.

I believe this can be done in a very broad way. We have this invention called the Internet. Many Canadians, perhaps not all, are able to access it. That is one tool we could use to ask Canadians who want to express their opinion to tell us, as parliamentarians, how they think we ought to do this.

We could set this up through a series of questions that Canadians could then answer. That could be made available to everyone. This is one possible scenario. It would be non-partisan and it would take place across Canada. For those who are unable to access the Internet, other ways could be made available for them to participate through public meetings, the mail and other ways of communication.

Then, collectively, as parliamentarians, we should look at that and decide how we need to respond.

[Dan Albas, Conservative, Parliamentary Secretary to the President of the Treasury Board]

Mr. Speaker, the speech of the member for Mississauga—Erindale was heartfelt and thoughtful. There is a reason why the people have returned him to the House several times. It is because he is able to enunciate and elaborate on many complex issues in a way that is respectful and that raises the tone, which I think most Canadians would like to see in Parliament.

The member raised concerns. He spoke about his father and the era in which his father practised medicine, protecting and trying to save and preserve life. He also raised his concern about future practitioners in the medical profession and how many of the questions we heard today would be foisted upon them.

I know, as a son of a solicitor who worked in a law office, that there are also ongoing challenges with what the member was saying regarding elder abuse, as well as establishing whether people had proper wills and that those wills were honoured and carried forward. Oftentimes, that is left up to the lawyer to carry out in very difficult situations.

Does the member also share concerns that there will be similar issues with the legal profession with this, because many Canadians still do not have wills? These are things that we all will have wrestle with collectively as this issue goes forward.

[Bob Dechert, Conservative, Mississauga—Erindale, ON]

Mr. Speaker, I thank my hon. colleague for his his kind comments.

As a lawyer, I have seen beneficiaries unfairly manipulate people who were ill and in a weakened state, and I think most lawyers have. One has to be very concerned about that. I witnessed my colleagues who were specialists in the area of wills and estates call those people out and refuse to witness a will that they knew the testator had been pressured to enter into. This takes it to another level, and people can be manipulated in that sense.

Once the will is in place stating the beneficiaries, I am concerned about the kind of pressure that those people could be put under to then say that they wish assisted suicide. We have to take the time to carefully consider those issues and ensure that the process that is put in place eliminates as much as possible the risks of this happening.

[Judy Sgro, Liberal, York West, ON]

Mr. Speaker, what is the government's plan?

We have put forward a proposal to start consultation. This is a very difficult and complex issue. It is probably one that none of us really want to have to deal with, but the reality is that the Supreme Court has referred it back to Parliament and has told us we have 12 months to come up with something. Therefore, we have put forward a proposal to start the process moving in a non-partisan way.

What is the government's proposal, other than putting something up on the Internet and talking about already asking for an extension, rather than starting to deal with this difficult issue?

[Bob Dechert, Conservative, Mississauga—Erindale, ON]

Mr. Speaker, there will be a broad consultation process. I am not informed of the whole design of that process to inform the member today, but it will be announced by the government very soon. I assure the member that it will be very broad.

I appreciate that the Liberals are trying to do something here, but it is the wrong method. Parliamentary committees do not have the ability to hear from thousands of people.

With respect to the 12-month period, this is a standard time that the courts use in cases of this sort. However, given the special circumstances of this issue, which is among the most important that we will ever have to deal with, and in the context of this year, I do not think we should be rushed into doing something that is inappropriate and not take the time to properly and carefully consider it and hear all opinions. There is a 12-month imposed deadline. There are opportunities for the government to ask the court for an extension. Given the circumstances of the issue and this particular year, I think the court would very likely consider those arguments.

[Françoise Boivin, NDP, Gatineau, QC]

Mr. Speaker, I will be sharing my time with the member for La Pointe-de-l'Île.

There are times in a person's life that are of critical importance. There is nothing more important than anything that affects our health and our lives and anything that affects the lives of the people we represent. There is likely nothing more important we will debate, except security, because this is once again an issue that affects the lives and freedoms of the people we represent. It is therefore an extremely important issue.

When I was fairly young—the word “young” is relative in this caucus—I suddenly had to deal with terms that I was completely unfamiliar with. When I was 29 years old, we learned quite suddenly that my father had cancer. He had only a short time to live. The doctors gave him two or three months. Even with treatment, he would have five months at most. I had to reconsider what principles and concepts such as quality of life and human dignity meant to me. There is nothing worse in life than being faced with your own mortality or the mortality of your loved ones. How should anyone deal with all of this? I think that the most important thing to focus on is being compassionate.

I am also lucky to be a Quebecker and to have observed the process in Quebec with the Select Committee on Dying with Dignity. One of my good friends, Maryse Gaudreault, the MNA for Hull, was a member of the National Assembly when her party was in power, and she chaired the committee.

What I found fascinating was that politicians of all stripes were able to come together to address this very complex issue. There were as many different positions as there were people around the table, but they were able to put their differences aside to work for the people they represented, for the greater good, as they say. These people were all open to ideas throughout the process. It is true that they took as much time as they needed. I agree with the parliamentary secretary: if we want to carry out a thorough study of the many different aspects of this issue, we should think about the time we will have to spend on it. That is why we cannot wait until tomorrow; we must start today.

The committee produced a report. There is an English version. I encourage members to consult the report on the Government of Quebec site by clicking on the Select Committee on Dying with Dignity tab. This is a model of political co-operation between politicians of all stripes. Call them what you will—federalists, sovereignists or separatists—whether they were on the left, on the right, in the centre or on the centre-left, these people all sat down around a table in a non-partisan way to listen to what Quebeckers had to say and to make recommendations.

It did not stop there. Indeed, after that, a committee of experts was put together to try to create a somewhat more legal context on the issue. Three prominent individuals took part: Jean-Pierre Ménard, an authority on medical law, Michelle Giroux and Jean-Claude Hébert. Work continued, and it was agreed that if the next government was not the same as the government that chaired the committee, they would carry on and continue the process. Therefore, it did not end when the government changed hands. The Parti Québécois minister, Véronique Hivon, took over and continued to handle the file, and then the Couillard government completed the process.

This shows how a cross-section of people with different backgrounds all got involved in this issue. They took the time to listen to the public and tried to develop a humane process that is respectful of rights and of people at higher risk in order to avoid what no one wants to see happen.

That being said, under the Canadian Constitution, the provinces have jurisdiction over health. That includes end-of-life care, regardless of when that happens.

I have a lot of respect for Quebec law, and I fully recognize Quebec's right—and the right of every province in the same circumstances—to do what it did. We are dealing with the Carter decision, which was rendered by the Supreme Court on February 6. The decision was very clear. It deals with section 241(b) of the Criminal Code, which states that anyone who aids or abets a person to commit suicide is guilty of a criminal offence. According to section 14 of the Criminal Code, “no person is entitled to consent to have death inflicted on him”.

The Supreme Court of Canada was very clear. In the words of the leader of the third party, the court provided “clear and unanimous guidance”. The Supreme Court of Canada could not be any clearer. We must therefore examine this issue in a very specific context. The Supreme Court of Canada stated unequivocally:

Section 241(b) and s. 14 of the Criminal Code unjustifiably infringe s. 7 of the Charter and are of not force or effect [it is important to clearly understand the Supreme Court's decision] to the extent that they prohibit physician-assisted death for a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition. The declaration of invalidity is suspended for 12 months.

In other words, there are not 36 possible scenarios. This has been discussed at length. We know the score. Everyone is talking about three possible scenarios and a fourth. The fourth scenario would be to seek an extension from the Supreme Court because we were unable to move forward with this matter quickly and do what we should have done a long time ago. The NDP started working on this long before the Carter decision, knowing full well that we must deal with this issue, even if only because Canadians asked us to. I keep getting the impression that Canadians are ahead of us on this issue.

The Supreme Court of Canada was clear. One of the three possible scenarios is to use the notwithstanding clause. We know that some Conservative colleagues are fond of that clause. I was pleased to hear the Minister of Justice say that the notwithstanding clause would not be used. Thank God. To make this clear to those watching us, using the notwithstanding clause in relation to the Canadian Charter of Rights and Freedoms means that we know we are not complying with the Charter, but we are knowingly doing that anyway. So far, every party has stayed far away from using that type of clause and I am glad about that.

The second scenario would be to say that nothing is happening and that we will not ask the Supreme Court of Canada for an extension. What is happening? A journalist asked me that question yesterday. It is interesting because the more we read the decision, the more things we see come to light. In fact, my opinion, for what it is worth, is that section 241 (b) will continue to apply, except for prohibiting “physician-assisted death for a competent adult person who (1) clearly consents...” or what I was referring to earlier. The laissez-faire or leave-it-alone scenario would mean that the courts would rule on a case-by-case basis.

The third scenario is to take the bull by the horns and provide clarification. The courts will nevertheless have to know what is meant by “competent adult”, “clearly consents to the termination of life”, “grievous and irremediable medical conditions (including an illness, disease or disability) that causes enduring suffering”, and so forth.

The New Democrat caucus has all kinds of opinions, just like the Canadian public. However, I think that we need to listen to Canadians, experts and people who have a special interest in this issue, so that we can be clear about how paragraph 241(b) should now read in light of the Supreme Court's ruling, and what would be an acceptable form of consent, as given by an adult, and so on. The idea of a committee is not a bad one.

We will support the Liberal motion. However, I have some serious doubts about whether the process can be non-partisan, in light of the history we have with the current government.

[Sean Casey, Liberal, Charlottetown, PE]

Mr. Speaker, I thank my colleague for her speech.

It is interesting to see the government's position. The Conservatives indicated that they are in favour of consulting people, but they are not in favour of a committee. Apparently, this is a role for the government only.

What role does my colleague think parliamentarians should play in the consultation process? Should their role be limited to simply examining the work of public servants? Does she think we have a real role to play in this process as members of the opposition?

[Françoise Boivin, NDP, Gatineau, QC]

Mr. Speaker, as MPs, we have an extremely important role to play in this because we are the people's representatives.

Each one of the 308 members of this House represents a percentage of the population, and must therefore take the pulse of his or her constituents. Do not think that I have not raised this issue during all of the activities I do in my riding. I am known for spending a lot of time on the ground in my riding. I ask people in my riding about this issue. Some people even ask me before I have had a chance to do it. They ask me what I think of the Supreme Court's decision, and I ask them what they think of it, where they stand and what they would like to see.

I get the sense that, on this issue, Canadians are maybe more mature and adult than the government. They are ready to listen to this conversation. Quebeckers have listened, but perhaps not the rest of Canada. The broad consultation that the parliamentary secretary was talking about, and rightly so, should be carried out in a non-partisan way, not by the government but by a representative group of MPs, so that we can all hear the same things instead of wondering whether we really got X, Y or Z's opinion. It has to be broad and non-partisan.

[Harold Albrecht, Conservative, Kitchener—Conestoga, ON]

Mr. Speaker, it is clear through the discussion this morning and I am sure to all members of Parliament, judging by the volume of information we are getting from our constituents, that this is a very crucial and a very sensitive issue for Canadians to deal with. It is my hope that we will take adequate time to study it and to hear from a broad spectrum of Canadians.

The concern I have with my colleague's comments, both in her speech now and in her earlier question to my colleague the parliamentary secretary, was her implication that somehow this party or this government has already made a decision, or will make a decision, irrespective of Parliament.

I need to remind her and all Canadians that all parties have dealt with this issue in Parliament. Nine different private members' bills introduced from 1991 to 2012 have dealt with this exact issue. Six of those bills failed to pass.

It is not this government that is making the decision. It is not this party. Parliament has spoken to this issue, and it is clear to me that if we are to deal with this issue now, we need adequate time to consult.

My question to the member is this: why, in an election year when we have many weeks out of the parliamentary calendar to study this issue adequately, would she oppose the idea of having a full 12 months of parliamentary time to study this very crucial issue?

[Françoise Boivin, NDP, Gatineau, QC]

Mr. Speaker, I will correct the hon. member. I do not oppose a study. What I would oppose strongly, though, would be a consultation of 12 months, or however many months, that was carried out solely by the government. That would be a big problem with me and our caucus. I think it is too big a question to be examined only by the government side.

That said, I understand the previous decisions and the previous facts that members of different parliaments had to decide on. We now face a decision from the Supreme Court of Canada, which is the top court, and we are still a country governed by the rule of law. I used to say on all the panels on which I sat with my colleagues who kept saying, “Oh, no, it is the Rodriguez decision. It is Rodriguez. It has been decided”, that we must beware and that we might have to decide to reopen the issue because a decision from the Supreme Court might be different.

If everybody waited for this actual moment after February 6, they would already be too late. They should have started.

[Ève Péclet, NDP, La Pointe-de-l'Île, QC]

Mr. Speaker, I have the honour of rising today to speak to assisted suicide and the motion by the third party in the House.

I would like to start by echoing the comments of all my colleagues. I will not go into a lengthy debate. This is a sensitive, very polarized issue that engages people personally because we have all directly or indirectly gone through a tragic situation where someone we know has lost a loved one or we ourselves have lost someone very close to us or seen a loved one suffer. Parliament's role is to guide Canadians in this kind of situation, to reach out and tell them that we will listen, answer their questions and ease their insecurity.

The debate is necessary today, and I would like to thank my colleagues in the Liberal Party for moving this motion. As they said, we are dealing with a very important Supreme Court decision because, as my colleague from Gatineau just said, it overturns another decision, the Rodriguez decision. It sets out new principles regarding euthanasia and assisted suicide. It is important that we, as parliamentarians, consider this decision and listen to the many Canadians from all walks of life who have been asking the government to do something for a long time.

My colleague from Gatineau mentioned this, and I could perhaps repeat certain principles set out in the court's decision. In its decision, the court indicates that paragraph 241 (b) and section 14 of the Criminal Code infringe Canadians' right to life, liberty and security of the person. Why? Because a blanket prohibition does not achieve the objective of protecting vulnerable people from being counselled or encouraged to end their lives. The blanket prohibition infringes the right to dignity. The Supreme Court speaks of autonomy in making decisions, liberty of the person, dignity of the person. It is important to acknowledge and espouse these concepts and to go back to Canadians so they can tell us what they think and what they expect from their Parliament.

It is unfortunate that the Conservatives believe that only the government can consult Canadians. That is false. We are all here as parliamentarians, and it is the role of parliamentarians and Parliament to consult Canadians.

With regard to what was done in Quebec, on behalf of all my colleagues, I would like to congratulate the members of the National Assembly. They were truly able to completely set aside political partisanship and finally passed the bill on June 5, 2014.

Quebec's process was very interesting. It began in 2009. From 2009 to 2014, a select committee mandated by the assembly to study the issue of the right to die with dignity came up with principles and considered the issue of assisted suicide very carefully. It consulted experts from September 2010 to March 2011.

Then it asked legal experts to comment on its 24 recommendations and table a report on the legal issues that were raised. That report was submitted to the government on January 15, 2013, and to the Committee on Health and Social Services.

People from every field affected by this issue were consulted, including legal experts and health and social services professionals. It is worth mentioning because the provinces have to be involved in the process, whether there is a special committee or consultation. The government has to understand that the provinces are key players in providing health care.

It is therefore extremely important for the provinces to be an integral part of the government's consultations. We must consult Canadians, legal experts and health professionals, but the provinces are on the front lines of health care delivery. Their point of view must be heard by the government.

This is not the first time a bill on assisted suicide has been introduced. In this case, it is a motion, but a number of bills have been introduced, including one sponsored by my predecessor, Francine Lalonde. She was a leader on the issue of assisted suicide. She introduced a bill to amend the Criminal Code a number of times. Parliament can also draw from the many initiatives by parliamentarians and the debates that have been held in Parliament.

People often contrast assisted suicide with palliative or end-of-life care even though the two go hand in hand. My colleague from Timmins—James Bay moved a motion calling on the government to establish a pan-Canadian palliative care strategy in partnership with the provinces and territories in order to enhance the quality of life and dignity of people who are, unfortunately, dying.

All of this warrants an extremely important discussion on the role that Parliament will play in this issue. The fundamental principles of this debate are very important. They are freedom, choice, dignity and, most importantly, health and security. These are the fundamental principles established by the Supreme Court in Carter v. Canada.

We need to see to it that all Canadians are heard and that they can end their lives in a dignified manner. The freedom to make decisions is extremely important.

The provinces must be the primary stakeholders consulted by the government, but Canadians need to feel that the government is listening to what they have to say and that it will do everything in its power to comply with the Supreme Court's decision and find a solution that respects the fundamental principles set out in Carter v. Canada.

[Bob Dechert, Conservative, Parliamentary Secretary to the Minister of Justice]

Mr. Speaker, I thank my colleague for her speech. I have the pleasure of serving with her on the Standing Committee on Justice and Human Rights, which deals with issues of the law such as the one before us today.

I wonder whether she thinks that the appropriate committee for this kind of study should be the justice committee of the House of Commons or this special creation. Second, I wonder if she would tell us whether she thinks the timeframe is sufficient.

Earlier in the debate we mentioned the Bedford decision and the government's response to the Bedford decision. In fact, the NDP asked at that time that the government go to the Supreme Court and ask for an extension, because it felt it needed more time for a committee review. The NDP kept saying things like, “What's the rush? Why are we rushing so hard? Why don't we take more time to deal with the prostitution issue?”

I wonder if she would comment on that and how it would apply to this issue.

[Ève Péclet, NDP, La Pointe-de-l'Île, QC]

Mr. Speaker, unfortunately, I do not have much time to answer my colleague's many questions.

It is not up to me, as a parliamentarian, to decide which committee is the most appropriate. It could be the Standing Committee on Justice and Human Rights, a special committee or an advisory committee. That is a decision that we must make here in Parliament. Legal and health experts from every province must play an important role in this process.

It is up to the government to determine the appropriate timeframe. However, given that it took the government a year to talk about prostitution, I do not see why it could not engage in a meaningful process on an issue as important as assisted suicide.

As for my colleague's comments on prostitution, I would remind him that the government waited until the last minute to introduce a bill, and that is why we were asking why the government was in a rush. There was a rush because Parliament had one year, but the government waited until the last minute to introduce a bill and rush it through the Standing Committee on Justice and Human Rights. We even had to sit in July, when Parliament was not sitting, to study the bill, and we had one week with some 60 witnesses—

[The Acting Speaker, Conservative, Barry Devolin]

Order. The hon. member for Trois-Rivières.

[Robert Aubin, NDP, Trois-Rivières, QC]

Mr. Speaker, I have been following this morning's debate very closely. I have no doubt that the Government of Quebec led the way here and that we would all do well to look to how the process was carried out in recent years.

However, I was almost pleasantly surprised to hear the parliamentary secretary say this morning that he wanted broad consultations. I think that is a good starting point. Where I became disillusioned was when we heard that broad consultation meant an Internet survey. Perhaps my colleague can alleviate my concerns.

I think that in dealing with such an important issue, the quantitative aspect—the number of people consulted—is important, but the qualitative aspect is especially important. No Internet survey, as objective as it may be, will allow us to see the people we are talking to. We cannot see their faces and read their body language to understand their feelings about this issue. Moreover, I am not sure how objective such a survey could be.

Is an Internet survey truly an appropriate way to conduct this consultation?

[Ève Péclet, NDP, La Pointe-de-l'Île, QC]

Mr. Speaker, I share my colleague's concerns.

We know how the Conservatives do consultation. One never knows exactly who, how or when they do it. They will probably do their consultation on euthanasia and assisted suicide online, just like they did their consultation on prostitution.

With regard to the process in Quebec, one of my colleagues reminded me that the select committee travelled the length and breadth of Quebec to gather a broad range of opinions, and that cannot be done online. It is extremely important to conduct broad consultations, but most importantly, we need to consult experts on the ground in the provinces.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Mr. Speaker, I will be sharing my time with the member for St. Paul's.

This motion is fairly simple. It is asking for a special committee to be set up to seek input from experts and to have a broad consultation with the public and with physicians because we are talking about physician-assisted death. The Supreme Court has actually talked about the very complex and controversial nature of the whole issue of the idea of assisted death. We know that some people are anxious and concerned that vulnerable people would be coerced. The Supreme Court spoke clearly to the idea that people could be coerced and abused and pushed into making decisions to end their life when it is not necessary. The court has balanced that with the idea that some people do feel they need to end their life for various reasons. Because of the very complex nature of this ruling and because of the very controversial nature of how Canadians see this, many groups should be consulted. It is important for us to deal with this controversy within the public realm, and also to speak to physicians who would be the people dealing with the issue of physician-assisted death.

The Supreme Court was very clear that this legislation has to be balanced. It must balance protection of the vulnerable from coercion, et cetera, and allow for that right to life, liberty, and security of the person, for people who are:

...a competent adult person who (1) clearly consents to the termination of life and (2) has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.

That is particularly clear. What the Supreme Court said is that any law must have “...properly designed and administered safeguards...capable of protecting vulnerable people from abuse and error”. The Court was very clear that we need to balance this. It is something about which we need to talk to the public. We need to hear from all the various groups and experts and from physicians.

The courts also said something very important. In the context of medical decision making and informed consent, physicians are fully competent and capable of assessing all of the criteria that the court spoke about earlier, which is about the adult person who is competent, et cetera. Physicians are the ones who diagnose a patient's condition, who know the prognosis of a patient, who understand all of the available choices that a patient has in order to relieve suffering and in order to look at the choices in terms of his or her life. Ending his or her life has to be one of those choices. Assessing competency is core when a physician is dealing with a patient.

Every day as a physician, I spent a lot of time with my patients, giving them the options for treatments and interventions, telling them exactly what their illness is about, what the prognosis is, and what the treatments may or may not be; and giving them every single option, so that at the end of the time patients are the ones who actually choose. It is called informed consent. They are given the information about what to do, where to go, and what decisions to make. This is just one more part of that informed consent, and physicians are the only persons capable of doing that, because they know how to assess competency. Physicians know when a patient is being coerced or abused. They know when a patient is able to understand the nature of his or her illness. Physicians are able to diagnose whether a situation is irremediable. They are able to assess whether the patient is in intolerable pain and whether there is no hope for the patient. In fact, in the context of life and death decisions, physicians are very capable of assessing these criteria.

In some jurisdictions, such as Oregon and Belgium, in Europe, we see that, in the decisions where there is physician-assisted death, there is always a second opinion. Many physicians, in the course of their discussions with their patient, will suggest getting a second opinion, so that patient hears from another qualified physician whether those options are indeed the only ones, and the patient is able to make the choices.

I think it is really important that physicians be able to do this, and I think the courts have said that they believe that physicians are capable of doing it.

One of the things we would have to look at, which is not widely accessible to anyone across the country right now, is an option for many patients who are finding themselves in intolerable pain or who are totally unable to have their condition remedied. That is the idea of palliative care. There is no palliative care accessible. I know that a physician would like to be able to tell a patient that there is a choice, that there is a place to go to for good palliative care, to relieve the pain a person may be experiencing and to do the kinds of things to help them die with dignity. Patients could then have a choice, but this is not a choice that is currently available across the country.

I want to stress that the Canadian Medical Association and I as a physician believe that palliative care is a key component to create as some kind of parallel program that would assist us when the legislation is being written, thereby offering these kinds of informed consent and real options to patients.

Suicide prevention programs need to be maintained, because we know that many patients who face a chronic, debilitating disease or an intractable illness become extremely depressed. It is one of the first things that happens to a patient when they are diagnosed with something that is intractable or life threatening. Therefore, they are not really making competent decisions because of depression. Good mental health care for patients who have been diagnosed with these illnesses is another option that is not currently available to patients. If we look at dealing with this issue, we have to give patients real options, so we need to expand these programs where necessary.

The second piece we need to discuss is to talk with physicians about legislation. The CMA has said clearly that it believes that the medical profession should be given adequate opportunity to comment or to have input into any kind of legislation, because we see clearly that physicians will be playing a great role.

We also know that physicians themselves are quite split down the middle on this issue. We know that physicians are torn between the two primary ethics. One is to consider first the well-being of the patient, which may very well be to assist that patient in dying with dignity. Second is to do no harm, which many physicians feel is an ethic that conflicts with that.

Therefore, there need to be clear protections, as currently exist in all jurisdictions globally that have legal physician-assisted suicide. They say that physicians who do not wish to assist a patient dying, for moral, religious, or other reasons, have an ethical and moral duty to refer that patient to a physician who will assist that patient.

These are some of the reasons that physicians have to be protected if they make a decision, as is currently the case in regard to abortion. If a physician for moral or other reasons will not perform an abortion, that physician has an ethical duty to refer the patient, if the patient wishes that to be done, to a physician who will do so.

These are very important issues on which we need to hear from physicians as we are crafting legislation. We need to look at best practices in other jurisdictions. That is an important piece.

However, the procedural component of this is very clear. The House will only sit for another 12 weeks. If we in fact get a committee to go now, to travel, to listen to Canadians and meet with experts and listen to physicians, we would be able, after an election with a new government of whatever political stripe, to meet the Supreme Court's deadline with a committee report.

Using a special committee is not without precedent. In fact, other special committees, such as the committee on solicitation, the special committee on the non-medical use of drugs, and the special committee on missing and murdered aboriginal women, have been precedents for this. It is because parliamentary committees have other roles to play in the course of their duties in looking at legislation and would not be able to carry out this job as completely and fully as a special committee could, whose only job would be to do that.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Mr. Speaker, what we are debating today is a motion to set up a committee to try to collect information so that the government can draft legislation to meet the Supreme Court of Canada deadline.

I am concerned about the 12 weeks. That is not a lot of time. A budget is coming up. We have the regular legislative stuff that we deal with all the time. There is the summer break and then there will be an election. Nothing is really going to happen until after the election on October 20, and it will take a couple of weeks for the government to get organized, so we are looking at November. We really are talking about a couple of months.

I wonder if Parliament should not recommend to the Supreme Court an extension of the 12-month timeline. Would the member agree with that?

[Hedy Fry, Liberal, Vancouver Centre, BC]

Mr. Speaker, the hon. member has just made a good case for having a special committee and not the usual parliamentary committee. A special committee could dedicate those 12 weeks to crossing this country and hearing from experts. That is a good reason to have a special committee.

However, we are dealing with people who today have intolerable pain. They are living with intractable disease and their time is growing near. We cannot ask them to hold off and wait. We must move with all speed and do the best that we can to get as much input as we can. That is why we want to set up a special committee and not the usual parliamentary committee. People who are suffering and in pain cannot wait for us to make these kinds of lengthy decisions.

[Sean Casey, Liberal, Charlottetown, PE]

Mr. Speaker, my colleague's perspective from her previous career as a doctor adds great value to this debate.

I want to stick to the theme of the apparent government strategy of seeking an extension of time. There is no guarantee that an extension of time would be granted. It strikes me as a strategy that is really fraught with risk. That is what I would like my colleague to expand upon. In the event that the government's strategy of asking the Supreme Court for an extension of time results in that request being rejected, what would be the consequences?